Effective health promotion and disease prevention rely on high quality health data. Currently, there is limited health data on culturally and linguistically diverse populations, particularly foreign-born non-English speaking (NES) older adults from collectivist cultures. Data collection challenges have been attributed to culture and language barriers. Congruent with the National Institute of Nursing Research's strategic plan to conduct research using innovative technology to identify effective methodologies and strategies to promote health and prevent diseases of patients and families, this study aims to fill a knowledge gap-culturally appropriate data collection methods for NES older adults. Older Hmong adults will be the focus of this study as they embody the characteristics of collectivist, foreign-born older adult populations and are non-literate. The objectives of this proposed study are to 1) test the feasibility and acceptability of a novel mode of data collection, using a specifc technology, audio-computer assisted self-interviewing mode (ACASI); and 2) explore the impact of collectivist culture, family member helper, on item response by including a family helper. This novel mode of questionnaire is culturally and linguistically appropriate for a dyad 1) whose members may differ in familiarity with Hmong language, and comfort with technology, and 2) who lives in a collectivist culture. A 36 item questionnaire will be presented (using ACASI), in oral Hmong and written English simultaneously. This approach acknowledges common language differences between older and younger Hmong, as well as the common, strong bonds across the generations in collectivist cultures and is culturally and linguistically congruent with both generations. A sample of 30 Hmong participant dyads will be recruited from two community centers in a Midwestern city. Older Hmong adults will take the online questionnaire with the assistance of their younger family member. Immediately following completion of the online questionnaire, a follow-up face-to-face interview will be conducted with the dyads to explore the feasibility of the ACASI questionnaire and the influence of including a family member helper. I will audio record the dyads during the online questionnaire completion process and follow-up interview. The audio recordings will be transcribed verbatim and then analyzed, using thematic analysis. The interaction process between the younger and older family members while deciding how to respond to each question will be analyzed quantitatively using event sequencing analysis, to explore the influence of collectivist culture on questionnaire responses. Results of this study can be used to increase our understanding of how data can be collected with foreign born, NES older adults from collectivist cultures and how they respond to questions about their health. This could ultimately lead to the development of a more robust dataset on health behaviors and health risks and improved health promotion interventions. This study will lay a foundation for the applicant's program of research to eventually develop and test behavioral interventions to promote health and prevent disease among marginalized immigrant populations.

Public Health Relevance

To advance health disparities research in health promotion and disease prevention, using new technology for data collection is needed to accommodate foreign-born, non-English speaking older adults from group-oriented collectivist cultures. Findings of this study could improve data collection from culturally and linguistically diverse older adult populations.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Predoctoral Individual National Research Service Award (F31)
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National Institute of Nursing Research Initial Review Group (NRRC)
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Banks, David
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University of Wisconsin Madison
Schools of Nursing
United States
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